Scalenes: Pain & Trigger Points

Tense scalenes can trigger pain in many body regions – from the front and back of your arms, to your chest and to your upper back –.

Treating this muscle group can be demanding as they are difficult to feel and massage.

1. Pain Patterns & Symptoms

Active trigger points in the scalenes can trigger pain in many regions of the body.

The deeper the red in the pictures, the more common it is to experience pain in the respective area, when trigger points are active.

The scalenes contribute to…

Visualization of the pain patterns


1.2 Symptoms & complaints

Compared to the diversity of pain patterns these muscles can create, there are not too many movements that may be impaired or painful when they are too tight or contain tender or trigger points.

The only ones I read about were a minimal limitation of neck rotation and some stiffness of your fingers on the same side.

2. Scalenes: Attachment Points

  • The scalene muscles consist of three parts.
  • An anterior/front, medial/mid and posterior/back part.
  • All three parts originate at the side of your neck vertebras and run to the first or second rib.

3. Scalenes: Function

When both sides of these muscles contract, they flex the neck. Contraction of just one side leads to a lateral flexion of the neck to the same side.

Furthermore, they help to lift the ribcage and assist the diaphragm during inhalation. Thus, they are assistant breathing muscles.


Flexion at the neck


Lateral flexion at the neck

4. Trigger Point Activation in the Scalenes

Although these muscles work during breathing at rest, they can get overworked during paradox breathing – breathing mainly with your chest –.

During paradox breathing your diaphragm is “not working properly”.

Among others, your scalenes will compensate for that, but as they are not meant to be the main workhorses, this kind of breathing can overload them quickly.

Furthermore, these muscles can be affected by any gait pattern that deviates from the norm.

This means limping, having a “shorter” leg or something similar can be the decisive reason why the scalenes get tense or develop active trigger points.

5. Palpation of the Scalenes

These muscles are partly hidden by your sternocleidomastoid.

This will make it a little challenge for you to feel them. So, take your time. You most certainly do not have to able to palpate them straight away.

5.1 Palpation of the scalenus anterior and medialis

To get onto the scalenus anterior – the one that sits in the very front – you need to move your sternocleidomastoid to the side.

To do so, pinch it with your fingers and then pull it a little forward into the direction of your voice box/larynx.

Now you can access the scalenus anterior. Place your fingers in the front of your neck to feel the muscle. You need to access it from the very front.

You are literally pressing the muscle against the neck vertebras.

Use the same technique to feel the middle part. Just feel at the side of your neck instead of the front.


Pulling the sternocleidomastoid away


Pushing against the scalenes

5.2 Palpation of the scalenus posterior

To palpate the posterior/back part of your scalenes, push with your fingers into the spot where your collarbone meets your trapezius.

6. Scalenes: Self-massage

Trigger and tender points can be found all over these three muscles.

To massage them, I recommend using your fingertips.

  • Press on the muscle part in question and pull skin over the muscle.
  • This way, execute a couple of short massage strokes.

Be aware that between the front and middle part there is a nerve running. Try not to get onto this nerve.

If you have difficulties massaging these muscles, I recommend seeing a professional and to ask for help. These muscles are not that easy to massage.

Still, if you find tender spots or trigger points, work them with slow and precise strokes.

Also be aware that you are applying a massage at your neck, which is a very sensitive part of your body.

So, I recommend being gentle and going slow.


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